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Home My WebLink About2267DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -2 -43 BOX 20 02267 IF i Is I LI N 16 L ._I L ` I ' n . 02267 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 August 25, 2006 Paul Savior 465 Lake Shore Road Putnam Valley, New York 10579 M Dear Mr. Savior: ROBERT J. BONDI County Executive ROBERT-MORRIS, PE Director of Environmental Health I'/ Addition — Savior, A- 254 -06 No Increase in Number of Bedrooms 465 Lake Shore Road (T) Putnam Valley, TM# 41.6 -2 -43 I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated August 25, 2006. The addition is approved with the following conditions: 1. The total number of bedrooms. must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower beads and faucets, etc. 4. This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. This approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals. Any other 'permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at (845) 278 -6130, ext. 2261. Sincerely, ek Gene D. Reed Senior Engineering Aide GDR:cj cc: Building Inspector, (T) Putnam Valley Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186. Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE MOUSE PLANS MUST BE SUBMITTED TO THE PCOOH FOR APPROVAL SIGNATURE & TITLE bAT ` ' ux* � � � � PLITIYAM COUNTY L)EPARTMENT OF HEALTH BEDROOMS TENTIAL ALL SUBSEQUENT REVISION/AL rERATIONS TO THESE HOUSE, BEDROOM PLANS MUST BE SUBMITT: D Tq�THE PCDOH FOR APPROVAL A. SIGNATURE TITI. ` ' ux* � � � � Y SHERLITA AMLER, MD, MS, FAAP Commissioner of Health t.s.._nA�.xn+a.f..ts i�..c v._nrt.. ems.: /YCmb ^sT>+^c��.� �... �- m.rt.•.w.., .ws .�:-- .. :_. LORETTA MOLINARI, RN, MSN Associate Commissioner of Health •OBERTJ.BONDI live '.1 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET leS LA Ke O TAX MAP# J41 o—A4S --: NAME �u M� : 02 PHONE $ - o PCHD# MAILING ADDRESS -46,5 DESCRIPTION OF ADDITION _ S�u�onn (25WASaA) 7q NUMBER OF EXISTING BEDROOMS Z. PROPOSED # OF BEDROOMS Z__) (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) "Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of.the Putnam County Sanitary Code. _. Please. submit_this form and the following to Putnam County. Health Dept.,_.1.Geneva. Rd, .. . Brewster, NY 10509; Phone:-(845)'278= 6130. " 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 3. Two sets of proposed floor plan (drawn to scale — with name, street and tax map #) *Non - professional sketches are acceptable 4. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 T SHERLITA AMLE1;4,M Z,�MS, FA9AP- Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count y ^ROBERT J. BONDi County Executive Re: SAVIOR (Owner's Name) Tax Map #: 41-6-2-43 Address: 465 Lake Shore Road Town: Putnam Valley Year Built: -1994 According to records maintained by the Town, the above noted dwelling, is XX in compliance with Town Code. is not . __.. _ in.- compliance with Town. Code. The Legal Bedroom Count is: 2 This information has been obtained from: Certificate of Occupancy: attached for addition Other: Assessor's Records Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 �•. >s'W01 M'::'+ -' 'm_. •vim BIRCH TOAD A I- . ;,;�-`• )tire �. `�� L� ��.�s :,. •� _ car., A :,4iy*ai� Off$ %$• ir. 4f1S'" 'P/ .''n. Td J.JN . $64 °46'30"E -1!'n sr/ •"65..6 :._j <� Non Aid O. /:r,O2W'O. 3..11 :1(�(, T m / • �" � �}� .•a tf. C a �- Proposed Addd/on LV sr: r l 4i1 �S'M 6d.0 e C'!�y).rS► j 10 fad:; . �.' .Sic :) a' ..f.' =� ;: •. `+.' = J '^�+ •Y• �� r, )Yid ; 6�6 _.� -. .. x" 0: a kaJp _ In •j h Q) y w S IOWA •• 11T SCALE NOTES. •;. +.' ?!�:,' �.,«• '4'`p . .' _ `�� / A//erolton of this document, except by o i• n d Land ,a'r'aT;r Surveyor, a d/ego! This mop a Cerhhed anty to ."' •: HZ. ?i 1'.. '��, ;i•, �•, 1. A// esrhheohons are vobd /or tArs mop oral mpl es PETER ONE .: o -s ;r: �•" m• thereof only /f sold map of cop/es bear the r Few f y P P /mpresced 1111th • OALE E!/ND /NC CORP.- �- :- �':.�T�.,,:...5� ='� seat o/ /Ae srreyor whose signature oppea� .•�f�`"�J ..11 rJ ;Areen. 11111111/ ad '!e COMMONWEALTH'LAND'773wE /NSf/RAMCE.b -0A~Y J. TAe prem/s/s Aerron are dls/gnoled or E, t. . +f NEB / /'rry� Prv/ssi i a /. o y 294 and 295 a-.. shorn cn that « -/o•a •. ,,, t;,,r : <`/' :. k. O,D 0 'Ssc '!':.:i;.i' • «.y r F:, ..c of Rcor/n 6rooX ' ti yT 2 ,F ?• -. g Late, rA/cA w• /•'au /� !G. ••ut vrn b «3 . vb •: 5$ County Cirri} Olhce as .4op 3L14E a, It 1.746. •.f 7J�`ni� s 4. ReviseN August /7, 1985 to show proposed n42••,nn. i�, BADEY 9 W rSON , "; Si Survey wos not brought to dote. LAND SURVEMRS •^• ;}nf:'i?.•. +' . - ' . ,.. s. �Y °; rf. 9 66 Morn St. " ROE UC.Mi /oe e� i Cold Spnng, N Y.:'• Atahopoe, N Y. .�jfg Stet (9/41'265 -92'8 (914) 628- 4494' • .. .. . "•"',':. r,Fb L A ti 1) .•'fG;::, 'T/TLE N9 XPP- R49J006 ' u x:•. V �s �� / Y , �r 4�l `1, • F x• t f. - ' 1' . g;'.: L' 7 :.S: - /i•s 'OF PROPERTY WEPARED NR g ER DINE W rW rE IN THE _ 'P,.UTNAM VA L L EY :v? :: •,,• .COUNTY . NEW YORK ✓ANUARY 15 , /975 V*fy :.1Aat the swvey shown hereon ; v'!nJ:: bnliory /5 1975, that i W *d. on � ' A"Xry 17 , 1975, 4hos'Deis p>AOared m accordance Ide.cf fiactice for Lond Surveys as r.Y>ars S/oN Association of� y A7rreyon, /ne_ Revised Aug. 12, 1985. r IDEY.. B W4TSOW $ AND SURVEYORS r rE Q/CENSED LAND Sl/RV£t'OR 4 'CENSE ND 49/6 -• • a hereby made for Description Bld , Location' Additions a- of Premises— Permit Work to start Street or Road sEC:�_ BLOCK oaring Brook bake ACRES (other. —� LOT y8UBp1 scriptianj o'r" number of — _ -- 1F- RO�NTA6 VISION NAME square feet OWNER Roaring Brook Lake Peter Dine DINE, PETER Roaring Brook Lake Jf- at once Depth ADDRESS RD #1 TEL• WiN, -Box 332 - TMI/7 -3 -16 (,q1• -= - ySJPERmjfi # 86 -1129 Addition 7/28/86 fff -7- ge* Y? - -9o.., 52639 -:�Tac- �p- FOXING: AS BUILT ........... .. -L_. CERTIFICATE OF OCCUPANCY - Add i t i o n Certificate of Occupancy No... 92�325 ...................Application No......... 8.6 � .Pete ofD Premises ..... ......... ..Lake.•;5'hore...�.rive....... HF3L •.....�'�,i�f 4. iI heretofore f' ............................... of465 Lak ..... 1 �,F.�l- 4:?............ sled a ........... . `S }fit.., n app for a buildin Ux* D� Code and the Laws m effect in the Town of putna 1..Valley, .t.f.X,... having Paid the r Pursuant to the Zoning Ordinance, Sanitary squired fee therefor and the �� Valley, Putnam Count the applicant has _subsequently Proceeded undersigned having b Y, New York, having tore in connpliattCe with the requirements with the erection orrsonal inspection ascertained that and materials met eve of h .the laws as aforementioned and that Proposed struc- rY requirement of the laws as aforementioned and now been fully completed and are read, for as the said .work therefore, this certificate of occu att cY Pursuant to the that the premises have Valley this P cy M hereby �• day of October b er by issued under the � Provisions of law, Now, valid .unless` .................................. .. 19...`>2 - , e.. .� ._. e..Town .of: Putn __ __. _ or. under signed- in ink by a d "tilt' authorized agent .. _. the seal of the Town of Putnam OWN O AM VALLEY, � am Valley. By................ ................ ACRES tother description) or number of square feet SUBDIVISION NAME Roaring Brook OWNER Peter Dine Lake TEL. ADDRESS Lake Shore Dr.- R.B.L. h ti I Dimension of Building Width Depth Stories Type Foundation Size & Use Each Room with Window Area USE CONST. ROOFING LAND 1 Family Wood Wood Shingle Paved 2 Family Steel Asb. Shingle Dirt Log Cabin Brick Tile Oiled Bungalow Concrete Metal Swamp Apartment Stone Brook Store FNDTNS. INTERIOR Lake F. Store & Apt. Stone Rooms Dams Store & Office Concrete Apt. Rooms Sw. Pools h ti I Dimension of Building Width Depth Stories Type Foundation Size & Use Each Room with Window Area f. . . 11 Aj �r/ o� '� a '� I � �� 0�.b CIA/W 'NO40 Cm O• J 4,,j - 1` Ck9A Dee 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PC HD Permit # Well Location: Street Address: Town/Village Tax Grid # './ /, to —2. - q3 �5 Lczl� e IV Pvf lxm Va / map Block Lot(s) Well Owner: Name: Address: kUd &nAtM yLI [,Jesf 7q' -hP- A/ V IVY 14V13 Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Dmca Amount of Use Yield Sought gpm # People Served Est. of Daily Usage _gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason o for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. Water Well Contractor: Aoad f�51 �'1 ov ' Co Address: 1fSZ 6:x"r-n-le l N V I ClS I Z Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: ___App Si_gnature:. =- LL PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water 11 driller certified by Putnam County. i Date of Issue )2,1 Permit P uin i : Date of Expiration L I Title: Q 0 �. Permit is Non - Transfers 1 White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97